Seminars in oncology
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Seminars in oncology · Feb 1994
Randomized Controlled Trial Comparative Study Clinical TrialThe role of granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor in chemotherapy for lung cancer.
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Seminars in oncology · Dec 1993
High-dose cytarabine, idarubicin, and granulocyte colony-stimulating factor remission induction therapy for previously untreated de novo and secondary adult acute myeloid leukemia.
This report describes the preliminary results of the remission induction phase of a protocol for previously untreated de novo and secondary acute myeloid leukemia (AML) designed to deliver very intensive therapy over a brief period of time using hematopoietic growth factor support. Remission induction therapy consisted of cytarabine 3 g/m2 (1.5 g/m2 for age > 50 years) intravenously over 1 hour every 12 hours for 12 doses and idarubicin 12 mg/m2 over 30 minutes on days 2, 3, and 4 of cytarabine, followed by 10 micrograms/kg granulocyte colony-stimulating factor subcutaneously daily until the absolute neutrophil count increased to > or = 5.0 x 10(9)/L on 2 consecutive days. Twenty-seven patients received all the planned doses of chemotherapy. ⋯ The use of granulocyte colony-stimulating factor is associated with rapid neutrophil recovery without obvious toxicity. The CR rate for de novo AML patients treated with a single course of high-dose cytarabine, idarubicin, and granulocyte colony-stimulating factor is at least comparable to CR rates achieved with standard-dose cytarabine and anthracycline regimens. The response of secondary AML patients remains inferior.
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Seminars in oncology · Oct 1993
ReviewThe platelet-refractory bone marrow transplant patient: prophylaxis and treatment of bleeding.
Refractoriness to platelet transfusions remains a significant problem for oncology patients, occurring in 30% to 70% of multiply transfused recipients with bone marrow failure. Nonimmune causes are often present and include disseminated intravascular coagulation, concurrent use of amphotericin B, infection, presence of palpable spleen, use of antibacterial antibiotics, bleeding, veno-occlusive disease, and fever. Immune causes are also commonly responsible for refractoriness, with HLA alloimmunization dominating the list of immune factors. ⋯ Platelet refractoriness continues to plague multiply transfused oncology patients. While preventative measures may ultimately benefit some patients, this problem will continue to manifest itself. A consistent approach to transfusion support needs to be implemented to best manage this challenging patient population.